Correct!
2. Focal area of consolidation in the left lung

By convention the CT scan is presented as if viewing the patient from the feet towards the head. Therefore, the abnormality is in the left lung (Figure 2).

Figure 2. Same as figure 1 with the abnormality circled in red.

The abnormality is rounded and has fuzzy margins. This could be solitary mass but in a bone marrow transplant patient with fevers the overwhelming likelihood is this is a focal area of consolidation.

Which of the following is the next best step for diagnosis?

  1. Bronchoscopy with bronchoalveolar lavage (BAL)
  2. Bronchoscopy with transbronchial biopsy (TBBx)
  3. Needle biopsy of the mass
  4. Observation with serial CT scans
  5. Video-assisted thorascopic biopsy (VATS)

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